Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients

Critically ill patients undergo significant pathophysiological changes that affect antibiotic pharmacokinetics. Piperacillin/tazobactam administered by continuous infusion (CI) improves pharmacokinetic/pharmacodynamic (PK/PD) target attainment. This study aimed to characterize piperacillin PK after...

Descripción completa

Detalles Bibliográficos
Autores: Martínez Casanova, Javier, Esteve Pitarch, Erika, Colom Codina, Helena, Gumucio Sanguino, Víctor Daniel, Cobo Sacristán, Sara, Shaw, Evelyn, Maisterra Santos, Kristel, Sabater Riera, Joan, Pérez Fernández, Xosé Luis, Rigo Bonnin, Raúl, Tubau Quintano, Fe, Carratalà, Jordi, Padullés Zamora, Ariadna
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/198337
Acceso en línea:https://hdl.handle.net/2445/198337
Access Level:acceso abierto
Palabra clave:Antibiòtics betalactàmics
Farmacocinètica
Farmacovigilància
Beta lactam antibiotics
Pharmacokinetics
Drug monitoring
id ES_2ba76d7f01d4ee4d93c040002ce7d4cb
oai_identifier_str oai:recercat.cat:2445/198337
network_acronym_str ES
network_name_str España
repository_id_str
spelling Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill PatientsMartínez Casanova, JavierEsteve Pitarch, ErikaColom Codina, HelenaGumucio Sanguino, Víctor DanielCobo Sacristán, SaraShaw, EvelynMaisterra Santos, KristelSabater Riera, JoanPérez Fernández, Xosé LuisRigo Bonnin, RaúlTubau Quintano, FeCarratalà, JordiPadullés Zamora, AriadnaAntibiòtics betalactàmicsFarmacocinèticaFarmacovigilànciaBeta lactam antibioticsPharmacokineticsDrug monitoringCritically ill patients undergo significant pathophysiological changes that affect antibiotic pharmacokinetics. Piperacillin/tazobactam administered by continuous infusion (CI) improves pharmacokinetic/pharmacodynamic (PK/PD) target attainment. This study aimed to characterize piperacillin PK after CI administration of piperacillin/tazobactam in critically ill adult patients with preserved renal function and to determine the empirical optimal dosing regimen. A total of 218 piperacillin concentrations from 106 patients were simultaneously analyzed through the population PK approach. A two-compartment linear model best described the data. Creatinine clearance (CLCR) estimated by CKD-EPI was the covariate, the most predictive factor of piperacillin clearance (CL) interindividual variability. The mean (relative standard error) parameter estimates for the final model were: CL: 12.0 L/h (6.03%); central and peripheral compartment distribution volumes: 20.7 L (8.94%) and 62.4 L (50.80%), respectively; intercompartmental clearance: 4.8 L/h (26.4%). For the PK/PD target of 100% fT(>1xMIC), 12 g of piperacillin provide a probability of target attainment > 90% for MIC < 16 mg/L, regardless of CLCR, but higher doses are needed for MIC = 16 mg/L when CLCR > 100 mL/min. For 100% fT(>4xMIC), the highest dose (24 g/24 h) was not sufficient to ensure adequate exposure, except for MICs of 1 and 4 mg/L. Our model can be used as a support tool for initial dose guidance and during therapeutic drug monitoring.MDPI AG2023202320232023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion16 p.application/pdfhttps://hdl.handle.net/2445/198337Articles publicats en revistes (Farmàcia, Tecnologia Farmacèutica i Fisicoquímica)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3390/antibiotics12030531Antibiotics, 2023, vol. 12, num. 3, p. 531https://doi.org/10.3390/antibiotics12030531cc by (c) Martínez Casanova, Javier et al., 2023http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1983372026-05-29T05:05:01Z
dc.title.none.fl_str_mv Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
title Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
spellingShingle Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
Martínez Casanova, Javier
Antibiòtics betalactàmics
Farmacocinètica
Farmacovigilància
Beta lactam antibiotics
Pharmacokinetics
Drug monitoring
title_short Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
title_full Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
title_fullStr Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
title_full_unstemmed Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
title_sort Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients
dc.creator.none.fl_str_mv Martínez Casanova, Javier
Esteve Pitarch, Erika
Colom Codina, Helena
Gumucio Sanguino, Víctor Daniel
Cobo Sacristán, Sara
Shaw, Evelyn
Maisterra Santos, Kristel
Sabater Riera, Joan
Pérez Fernández, Xosé Luis
Rigo Bonnin, Raúl
Tubau Quintano, Fe
Carratalà, Jordi
Padullés Zamora, Ariadna
author Martínez Casanova, Javier
author_facet Martínez Casanova, Javier
Esteve Pitarch, Erika
Colom Codina, Helena
Gumucio Sanguino, Víctor Daniel
Cobo Sacristán, Sara
Shaw, Evelyn
Maisterra Santos, Kristel
Sabater Riera, Joan
Pérez Fernández, Xosé Luis
Rigo Bonnin, Raúl
Tubau Quintano, Fe
Carratalà, Jordi
Padullés Zamora, Ariadna
author_role author
author2 Esteve Pitarch, Erika
Colom Codina, Helena
Gumucio Sanguino, Víctor Daniel
Cobo Sacristán, Sara
Shaw, Evelyn
Maisterra Santos, Kristel
Sabater Riera, Joan
Pérez Fernández, Xosé Luis
Rigo Bonnin, Raúl
Tubau Quintano, Fe
Carratalà, Jordi
Padullés Zamora, Ariadna
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Antibiòtics betalactàmics
Farmacocinètica
Farmacovigilància
Beta lactam antibiotics
Pharmacokinetics
Drug monitoring
topic Antibiòtics betalactàmics
Farmacocinètica
Farmacovigilància
Beta lactam antibiotics
Pharmacokinetics
Drug monitoring
description Critically ill patients undergo significant pathophysiological changes that affect antibiotic pharmacokinetics. Piperacillin/tazobactam administered by continuous infusion (CI) improves pharmacokinetic/pharmacodynamic (PK/PD) target attainment. This study aimed to characterize piperacillin PK after CI administration of piperacillin/tazobactam in critically ill adult patients with preserved renal function and to determine the empirical optimal dosing regimen. A total of 218 piperacillin concentrations from 106 patients were simultaneously analyzed through the population PK approach. A two-compartment linear model best described the data. Creatinine clearance (CLCR) estimated by CKD-EPI was the covariate, the most predictive factor of piperacillin clearance (CL) interindividual variability. The mean (relative standard error) parameter estimates for the final model were: CL: 12.0 L/h (6.03%); central and peripheral compartment distribution volumes: 20.7 L (8.94%) and 62.4 L (50.80%), respectively; intercompartmental clearance: 4.8 L/h (26.4%). For the PK/PD target of 100% fT(>1xMIC), 12 g of piperacillin provide a probability of target attainment > 90% for MIC < 16 mg/L, regardless of CLCR, but higher doses are needed for MIC = 16 mg/L when CLCR > 100 mL/min. For 100% fT(>4xMIC), the highest dose (24 g/24 h) was not sufficient to ensure adequate exposure, except for MICs of 1 and 4 mg/L. Our model can be used as a support tool for initial dose guidance and during therapeutic drug monitoring.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/198337
url https://hdl.handle.net/2445/198337
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/antibiotics12030531
Antibiotics, 2023, vol. 12, num. 3, p. 531
https://doi.org/10.3390/antibiotics12030531
dc.rights.none.fl_str_mv cc by (c) Martínez Casanova, Javier et al., 2023
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Martínez Casanova, Javier et al., 2023
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 16 p.
application/pdf
dc.publisher.none.fl_str_mv MDPI AG
publisher.none.fl_str_mv MDPI AG
dc.source.none.fl_str_mv Articles publicats en revistes (Farmàcia, Tecnologia Farmacèutica i Fisicoquímica)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869405172054097921
score 15.811543

Similares en LA Referencia